Dementia is often perceived to be part of normal aging, and families are less likely to present to health services, which in any case are often ill-equipped to meet their needs.119,120 Awareness and understanding about dementia are lacking and stigma is rampant. A randomized controlled trial evaluated a home-based

intervention in Goa, India consisting of basic education about dementia and common behavior problems, strategies Inhibitors,research,lifescience,medical for managing problem behaviors, support to caregivers in activities of daily living, referral to psychiatrists or other medical professionals for assistance with BPSD, networking to assist the caregivers to form support groups, and advice on government provisions for the elderly. The intervention led to Inhibitors,research,lifescience,medical significant improvements in caregiver mental health and perceived burden. There were also reductions in the behavioral disturbances and improvements in the functional abilities of the dementia care recipients, but these were nonsignificant.119 The program used local health and human resources, making it affordable and easily accessible. The small sample size (41 caregivers received the intervention Inhibitors,research,lifescience,medical and 40 were controls) was a limitation,

and possibly explained the lack of significance in the impact on the dementia patients’ behavior. Additionally, the 6-month follow-up 5-FU mouse period may have been too short to demonstrate an effect, or to show whether the intervention had a long term impact on caregiver and care receiver well-being. Special categories of caregivers There are certain groups of caregivers who may experience Inhibitors,research,lifescience,medical additional challenges beyond those directly related to caregiving. Homosexual partners of people with dementia often feel that existing interventions and support services do not meet their needs, or address the

Inhibitors,research,lifescience,medical issues they face (for instance next of kin rights). Moore121 reported that gay caregivers experienced prejudice and insensitivity in their interactions with health services, lacked social and emotional support due to efforts to maintain privacy in their relationship, were unable to use employee benefits to only assist their partner with dementia, faced opposition from employers when attempting to take compassionate leave, and experienced legal difficulties with estate planning.121 People from ethnic minorities, including indigenous groups, are less likely to have access to and to use mental health services.122-124 Contributing factors include a lack of understanding about dementia, language barriers, or other communication barriers, lack of GP knowledge of cultural differences in expression of mental illness and distress, distrust of Western medicine, ethnocentric attitudes and incorrect assumptions (for instance that certain ethnic groups will look after their relatives and do not require services).